Argentina Rematch

97112 Nueromuscular re-education CPT code is used for activities that facilitate re-education of movement, balance, posture, coordination, and proprioception/kinesthetic sense

True

Workers compensation insurance coverage will not cover an employee in the following situation

driving directly from work to home

For 5 spinal regions adjusted, the chiropractor would use code

98942

Billing and coding are the primary method of communication between the medical practitioner and insurance payor

True

Employers/unions establish healthcare funds to pay health costs of employees/union members. Theses plans are called

self insured plans

97110 Therapeutic exercise CPT code is paid by most insurance companies because it implies the promotion to wellness instead of passive care modalities. It includes active exercises, active assisted exercises, and passive exercises.

True

Per Dr. Robb Russell, who pays for Worker’s compensation? Choose all correct.

cost of goods sold, employers

“XS” is a new Medicare modifier. It has been widely recognized, but will likely become adopted by most insurance carriers due to the widespread 59-modifier abuse.

True

The request for authorization form in Worker’s Compensation must be postmarked within 20 days

False

Medicare Category II ICD-10 codes may have visits for full treatment

18-24

People claiming delayed onset injuries such as lung disease from chemical exposure are not eligible for Workman’s Compensation Insurance.

False

This modifier should be used to indicate that the physician’s office has signed an Advanced Beneficiary Notice and it is retained in the patient’s medical record. The notice is for services that may be denied by Medicare

GA

A single ABN is acceptable when it identifies all items and/or services and duration of period of treatment if no treatment changes have occured and services have not been added or deleted.

True

The application of heat packs, ice packs, UV radiation are _____ category for Physical Medicine

supervised

Which one of the following is not to be used upon filling out a Medicare insurance form

punctuation

____ is the site/agency that will issue your NPI

CMS

Which one of the following is not true in regards to Worker’s Compensation insurance coverage:

paid only after the employee’s health insurance has been billed first

The Worker’s Compensation Insurance and Safety Act of 1917 was established to

all of the above (tie injury costs to the costs of goods sold, encourage safety regulations, to insulate employers from lawsuits)

The PR-2 form in Worker’s Compensation must be filed within ____ days

45

Which one of the following does not apply to a valid Worker’s Compensation scenario/claim

hurt at any time while wearing a company uniform

Bank savings accounts allowed by the federal government for employees to take out a certain percentage from their pre tax wages and use to pay medical deductibles, co-pays, pharmacy, optical and other health related expenses are called

HSA/FSA

The proper way to display the date on an insurance form is

MM/DD/YYYY or MM/DD/YY

Of the three major skill sets in coding, pulling elements from your history and physical exam regarding signs, symptoms, and co-morbidities is called ______

abstracting

Medi-gap or Medicare Supplemental insurance is free and covers all healthcare costs that regular medicare does not cover

False

Medicare defines a subluxation as _____

All

Dr. Sam Collins recommended how to evaluate insurance companies to decide to be in or out of Network. Which of the following are his criteria? Choose all that are correct

The earliest age to meet the requirements for Medicare is ___ years (not including those who qualify for early Medicare retirement)

65

The ending code “S” (after the X) of a ICD-10 code specifically means

sequelae

A patient is considered an “established” patient if they have been seen in your office ever within the past ____ years

3

A Worker’s Compensation Claim Adjuster can deny payment if the doctor’s notes do not Justify the treatment rendered

True

The doctor must diagnose to the highest level of

specificity

When there is a change in the patient’s condition and the doctor wants to request more treatments for the Work Comp injury, and the doctor has documentation to justify these extra treatments, the doctor must send which form to the insurance claim adjuster?

RFA (request for authorization)

According to Medicare “MLN” SE0749, May 7, 2019. “Chiropractors may be Par or Non-Par, but they cannot opt out

True

P.A.R.T is the system Medicare requires for documentation of your diagnosis. You must document a minimum of one of the four (pain/asymmetry, ROM, tissue tone)

False

These are the key principles of a personal injury case

A and b (liability and diagnosis, MIST, prognosis and disability)

What is the usual maximum number of treatments allowed in California for Workman’s compensation injuries?

24

The following are not covered by Worker’s compensation coverage

all of the above

The -59 modifier is used to identify a separate procedure that was performed to a different area of the body on the same day as treatment to another body area was rendered

True

The insurance crime bureau “NCIB” collects data on all insurance claims in the United States for all doctors, all patients, and all homeowners on any claim filed.

True

Prognosis is the cornerstone of a personal injury case

False

The -25 modifier is used to

signify a separate E&M service performed with another procedure

MIST auto cases are

all of the above

Regarding treatment codes: the level of care is determined by the diagnosis

True

Rules and regulations about healthcare have been documented in

The code of Hammurabi

Which one of the following would apply in order for the “Notice of Personal Chiropractor” to be recognized and executed by the employee in a current Worker’s Compensation injury

filed with the employer prior to an injury